Provider Enrollment has become an essential competency for Medical Service Professionals and our research has demonstrated the core function this expertise plays in the profession to become Tomorrow’s MSPs.
NAMSS wants to help YOU become a Provider Enrollment MSP.
CPES Exam Reference Materials
Exam questions are based on a wide variety of publications, regulations, and resources in the Provider Enrollment field.
*Suggested preparation for the examination may include, but is not limited to, the following resources:
Select each resource to find suggested study materials
Learn More about the CPES Exam
Virtual CPES Certification Preparation Course
This course is designed to provide a comprehensive understanding of provider enrollment within the healthcare landscape. Participants will gain the knowledge and skills necessary to navigate the complex regulatory and accreditation requirements that govern provider enrollment. The course emphasizes maintaining compliance, conducting enrollments and ongoing monitoring, and supporting effective departmental operations. Participants will engage in case-based discussions, real-world scenarios, and practical applications designed to support both new and experienced professionals working in medical staff services, provider credentialing, and healthcare operations. The curriculum aligns with industry standards and supports compliance with accrediting bodies and regulatory agencies.
Course Learning Objectives:
By the end of this course, participants will be able to:
- Describe the end-to-end provider enrollment process and identify key regulatory and payer requirements.
- Apply federal and accreditation standards to maintain compliant enrollment practices.
- Develop and implement ongoing monitoring strategies to ensure provider compliance and mitigate risk.
- Support efficient departmental operations through communication, data management, and collaboration with key stakeholders.
- Identify common challenges and apply best practices for resolving enrollment-related issues.
NOTICE: The Virtual CPES Preparation Course for July/August 2025 is currently at capacity. If you would like to be notified of our next offering add your name to the waitlist!
Virtual CPES Certification Preparation Course
CPES Study Guide - Coming Soon
The CPES Study Guide is planned to be released this Fall. If you are interested in receiving more information about the CPES Study Guide and CPES Certification feel free to sign up for the CPES interest list.
*Disclaimer: NAMSS does not recommend purchase of all items listed. The Certification Commission of NAMSS (CCN) does not develop, administer, sponsor, endorse, or financially benefit from any type of exam review, preparatory course or published materials related to the content of the certification examinations. The purchase and/or use of any exam preparation material does not guarantee a passing score on the exam.
Provider Enrollment Glossary
Understand key terms related to provider enrollment practice. As defined in the Tomorrow’s MSP®: The Future of the Medical Services Profession report, provider enrollment has been identified as a core function of the profession.
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Provider Enrollment Series
- Mastering provider enrollment 101.
- Enhancing healthcare efficiency: unraveling the link between provider enrollment and credentialing.
- Elevating provider enrollment and credentialing: navigating a career transition and overseeing combined functions.
- Streamlining provider enrollment: maximizing efficiency with CAQH.
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Synergy Articles
“When I’m asked about the work that I do and I respond with “provider enrollment”, I’m met with a lot of blank stares….”
“2023 is bursting with provider enrollment updates that impact hospitals, durable medical equipment, prosthetics/orthotics & supplies (DMEPOS) organizations and ordering & referring providers…”
“Payer enrollment: two words that can strike fear into any CFO…”
"Provider enrollment is a critical yet often overlooked aspect of healthcare operations. It plays a fundamental role in..."
"In our organization, provider enrollment evolved from each practice changing their own enrollment process into a more centralized specialist one for the employed practitioners. The duplication of requests..."
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Webinar Recordings
I Am New to PE ... What Do I Need to Know? What Resources are Available?
- Understand the significance of provider enrollment for healthcare professionals and suppliers in participating in various programs and health plans.
- Identify the types of documentation required for provider enrollment, including credentials, licenses, certifications, and tax IDs.
- Learn the step-by-step process of enrollment application, including tips for completing applications efficiently and accurately.
- Recognize the importance of adhering to enrollment timelines and strategies for managing potential delays.
- Gain knowledge of revalidation and maintenance requirements, including the importance of keeping information up to date.
Latest updates impacting Medicare provider enrollment
- Review the latest Medicare regulatory & manual changes impacting the preparation of the Medicare enrollment forms.
- Discuss the recent Medicare enrollment form version changes and expanded definitions and provider/supplier types.
- Understand the current status of Medicare revalidations, tools to monitor and deactivation/reactivation procedures for lack of response.
- Learn about the new “Stay of Enrollment” status recently implemented by CMS.
It Just Makes Cents: Integrating Enrollment & Credentialing
- Learn the tools and perspective needed for your organization to leverage this opportunity to achieve greater efficiency and enhance revenue
- Using case studies, learn different methods to successfully integrate enrollment and credentialing
Provider Enrollment Revalidation & Roster Maintenance
- Learn how to organize provider information for a streamlined process.
- Understand how the revalidation process works.
- See examples of how to fill out a roster for roster maintenance.
- Have a better understanding of the roles and requirements as a provider enrollment specialist.
More Webinar Recordings
Conference Recordings
A payer enrollment case study: from outsourced to in-house
- Review the complete timeline of moving outsourced Payer Enrollment services to in-house acquisition including communication, training, and growing.
- Explore each step of the transition, the good, the bad and the ugly (on all sides) Detail the learning opportunities, mentorship, and driving decisions.
- Identify how recruiting “green” MSPs benefits a successful Payer Enrollment process.
2024 Annual Conference Recording: Provider Data Quality: How Rosters Drive Business Outcomes
- Explore the drivers that are creating low-quality provider data, from non-standard information collection to inconsistencies in data exchange.
- Gain insight into the key levers available for driving meaningful change to improve provider data accuracy.
- Learn the steps required to improve processes and reduce the administrative burden associated with provider data management.
2024 Annual Conference Recording: Enrollment Triage: Executive Buy-In and Direction
- Upon completion, participants will be able to define the benefits of a steering committee for provider allocation that includes all stakeholders.
- Upon completion, participants will have resources to build their own framework for communicating key milestones of the credentialing/enrollment process to stakeholders.
- Upon completion, participants will be able to identify and communicate to senior leaders the red flag areas that hinder timely and successful onboarding.
More Conference Recordings
Tomorrow's MSP Podcast
In honor of Celebrate Diversity Month, host Karen Claxton, MBA, CPCS, CPMSM, FMSP, spoke with three diversity, equity, and inclusion (DEI) leaders, Young Caldwell, MBA, CPCS, CPMSM; Kenickay Prendergast; and Ashlee Joselin, CPCS. Hear inspiring stories about their support of DEI initiatives in the medical services profession and discover ways to embody diversity and inclusion in your career and personal life.
As we ring in the new year, most MSPs are looking ahead to explore fresh opportunities and reach new goals in 2024. In this episode, host Lisa Goodwin, MBA, CPCS, CPMSM, spoke with Monica Martin, MA, CPCS, and Alison Webster, MBA, CPCS, CPMSM, CPHQ, FMSP, about recent achievements they’ve accomplished and how to stay motivated through reaching your goals.
On this episode, Natalie Rose, MHS, CPCS, CPMSM, Director of Credentials Verification Organization (CVO) with Trinity Health Center for Practitioner Information, Mindy Rodgers, CPCS, CPMSM, Senior Project Manager within the Provider Network at Optum, Dwaina Humphries, CPCS, CPMSM, Senior Training and Quality Assurance Coordinator with Novant Health Credentialing and Medical Staff Operations, and Amanda Meekins, CPCS, CPMSM, Director of Medical Staff Services at St. John's Health discuss the benefits of becoming certified and how MSPs can get involved with the NAMSS Certification Commission.
On this episode of the Tomorrow's MSP Podcast, Mathieu Gaulin, Director of Health Affairs with Boston Children's Hospital, speaks about how Provider Enrollment is an essential competency for MSPs and how NAMSS' Provider Enrollment series can aid MSPs in being effective gatekeepers of patient safety.
In the season 2 premiere episode of the Tomorrow's MSP Podcast, Heidi Thompson, MBA, CPMSM, CPCS, FMSP, System Director of Medical Staff Services at St. Luke’s Health System speaks to the importance of managing up as a career skill and why succession planning is integral to the leadership capabilities of future generations of MSPs.
Tomorrow's MSP Podcast
Provider Enrollment Competencies
Understand the core competencies, skills and requirements for provider enrollment job opportunities. These resources include insights into level of experience and expertise.
Growing your career as an MSP
Leadership Opportunities
- NAMSS Mentorship Program – NAMSS Membership Required
- The NAMSS Mentorship Program reflects our commitment to you and your professional development. This unique online networking and career development tool helps you find, connect, and share experiences with others. Your mentor or mentee can be in the same city or on the other side of the world.
- Become a Leader with NAMSS
Other Resources
- MSP Resources
- Defining Tomorrow’s MSP®: The Future of the Medical Services Profession Report
- Advocacy Tool Kit
- Industry Resource List
- MSP Profession Recruitment Toolkit
Tomorrow's MSP® is registered in the U.S. Patent and Trademark Office as a service mark of National Association Medical Staff Services.